Transient Abnormal T Waves in the Normal Adolescent.

FIGURE 1: Clinically normal 18-year-old girl. T HE SERIAL TRACINGS TAKEN 15 MINutes apart are from a clinically normal 18-year-old girl with an innocent heart murmur. The initial resting electrocardio-gram (Fig. 1) is abnormal because of the low voltage of all T waves, with definite inversion of T in V3. Fifteen minutes later, the tracing was repeated and normal T waves are present (Fig. 2). Both tracings were taken in the fasting state in the re-cumbent position. *From the Cardiac Consultation Service, Bureau for Handicapped Children, New York City Department of Health. Many benign factors may cause " functional " T wave changes. Therefore, abnormal T waves are sometimes seen in normal patients. These changes are usually temporary. They may be caused by the effects of respiration, posture, position, sympathetic-parasympathetic imbalance (note the wandering pacemaker in lead V2), cooling of the precordial region, food intake, rotation of the heart, anxiety, fear, drinking ice water, and hyperventilation. Electrocardiographers must be alert constantly in order to avoid false interpretation